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Public sector contracting report : the monthly guide to Medicare and Medicaid managed care最新文献

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Colorado providers prove safety net's place in Medicaid risk. 科罗拉多州的医疗服务提供者证明了安全网在医疗补助风险中的地位。

At least one system in Denver is proof that safety net providers can succeed in Medicaid risk. Find out how one provider and its partners went from fearing managed care to specializing in it.

丹佛至少有一个系统证明了安全网提供者可以在医疗补助风险中取得成功。了解一家医疗服务提供商及其合作伙伴如何从害怕管理式医疗转变为专注于管理式医疗。
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引用次数: 0
Can hybrid Medicare plan solve utilization woes? 混合型医疗保险计划能解决利用率问题吗?

Reducing inpatient hospitalizations as a way to control senior members' costs causes outpatient utilization to rise. The answer may lie in creating a hybrid Medicare plan that combines managed care with medical savings accounts. Learn more about the kinds of plans that may exist in the future.

减少住院治疗作为控制老年会员费用的一种方式,导致门诊使用率上升。答案可能在于创建一个混合医疗保险计划,将管理医疗与医疗储蓄账户结合起来。了解更多关于未来可能存在的各种计划。
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引用次数: 0
Medicare 'mega reg' offers providers mixed bag. 医疗保险“超级注册”为医疗服务提供者提供了好坏参半的服务。

Although the Medicare+Choice regs mostly cover how plans will operate, they also include provisions that will directly, and indirectly, affect Medicare risk providers. Find out how some of these rules might impact you.

尽管“医疗保险+选择”的规定主要涵盖计划的运作方式,但它们也包括直接或间接影响医疗保险风险提供者的条款。看看这些规则是如何影响你的。
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引用次数: 0
Potential for provider profits exists under one model. 在一种模式下存在提供商利润的潜力。
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引用次数: 0
Mississippi Medicaid program targets drug therapy compliance. 密西西比州医疗补助计划的目标是药物治疗依从性。

Can pharmacists serving as disease management and drug therapy counselors to patients help reduce Medicaid costs? Program administrators hope so as they launch a new effort in which pharmacists serve as providers of disease management services and are paid for having counseling sessions with recipients.

作为疾病管理和药物治疗顾问的药剂师能否帮助降低医疗补助的成本?项目管理者希望这样做,因为他们发起了一项新的努力,药剂师作为疾病管理服务的提供者,并通过与接受者进行咨询会议而获得报酬。
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引用次数: 0
Compliance plan can head off problems with Medicare fraud and abuse laws. 合规计划可以防止医疗保险欺诈和滥用法律的问题。

Don't assume that compliance issues are only for your Medicare managed care organization. Providers who don't understand how HIP AA and the BBA work together to hold providers and plans accountable for fraud and abuse can set themselves up for career-ending mistakes, experts warn. Here's how to avoid practices that could be considered Medicare fraud or abuse.

不要认为合规问题只存在于你的医疗保险管理医疗机构。专家警告说,那些不了解HIP AA和BBA如何合作来追究医疗服务提供者和医疗计划对欺诈和滥用行为的责任的医疗服务提供者,可能会导致他们自己的职业生涯结束。以下是如何避免可能被视为医疗保险欺诈或滥用的做法。
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引用次数: 0
Six questions to ask when eyeing Medicare pharmacy risk. 在考虑医疗保险药房风险时,需要问六个问题。

Don't be surprised if your Medicare HMO asks you to take risk for pharmacy. As the cost of the benefit skyrockets, plans are turning to providers who do the prescribing to better control it. Here's how to determine whether you should take the risk and some tips on what should be in your contract.

如果你的医疗保险组织要求你承担药费风险,不要感到惊讶。随着福利成本的飙升,计划正转向开处方的提供者,以更好地控制成本。以下是如何决定你是否应该承担风险,以及一些关于合同内容的建议。
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引用次数: 0
Survey highlights trends in managing Medicare drug costs. 调查强调了管理医疗保险药品成本的趋势。

Data File: Before you assume risk for your Medicare risk plan's pharmacy benefit, you ought to understand what the benefit is, how it works, and how much it's likely to cost you. Find out the latest trends and benchmark data in managed Medicare pharmacy from a recent survey.

数据文件:在你为你的医疗保险风险计划的药房福利承担风险之前,你应该了解福利是什么,它是如何运作的,以及它可能花费你多少钱。从最近的一项调查中找到管理医疗保险药房的最新趋势和基准数据。
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引用次数: 0
Tap your own Medicare risk members to supply needed social services for peers. 利用你自己的医疗保险风险成员为同伴提供所需的社会服务。

Start a Medicare peer volunteer program to meet your members' social service needs: For 11 years, Elderplan Inc. has used senior volunteers to effectively and inexpensively meet the social service needs of its frail and homebound members, plus gained loads of favorable publicity and community goodwill in the process. Find out the benefits of such a program and get some tips on how to start one at your organization.

启动Medicare同伴志愿者计划来满足会员的社会服务需求:11年来,Elderplan Inc.利用老年志愿者有效而廉价地满足其体弱和居家成员的社会服务需求,并在此过程中获得了大量有利的宣传和社区善意。找出这样一个项目的好处,并获得一些如何在你的组织中启动这样一个项目的建议。
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引用次数: 0
Invest in data systems to manage your senior patients. 投资数据系统来管理你的老年病人。
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引用次数: 0
期刊
Public sector contracting report : the monthly guide to Medicare and Medicaid managed care
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